The selegiline patch (EMSAM) is the MAOI with no diet rules at 6 mg. A PMHNP protocol for candidates, washouts, dosing, tyramine, and monitoring in TRD. In this Deep Dive episode, two hosts walk through “Selegiline Patch for TRD: A PMHNP Prescribing Protocol” from the Psych NP Fellowship blog by Lindsay Hill, DNP, PMHNP-BC. Key takeaways: • The selegiline transdermal system (EMSAM) is an FDA-approved MAOI for adult major depressive disorder, and at 6 mg/24 hours it needs no tyramine diet. • A 2025 real-world cohort of 117 patients with treatment-resistant depression found the patch was 0.81 CGI-S points better than tricyclics and better tolerated than oral MAOIs, with no hypertensive crises or serotonin syndrome. • The washout is the dangerous part: about 1 week off most antidepressants, at least 5 weeks off fluoxetine, and 2 weeks after stopping  ...